Representation in Medicine

During part of the rotation, the preceptor structured the clinic so that we would see the patients first, then present their cases to him. The patients varied, some being new and others well established. This setup helped us become more comfortable with the clinical process and encouraged us to start thinking like doctors rather than just reciting facts for board exams. Once the nursing staff arrived, they assigned us our first rooms.

I was relieved to see that I had been assigned an established patient. It calmed my nerves a bit, as I could review their chart beforehand and get a sense of what to expect before entering the room. After going through the chart, I felt more confident, knowing my task was simply a routine checkup for a 3-year-old girl. Little did I know that I was in for quite a surprise.

In the room sat a mother and her 3-year-old daughter, both with complexions similar to mine. To my embarrassment, I hadn't even noticed this at first, as I was so focused on the checkup that I overlooked who the patient was. Seeing them made me realize I needed to view them as people, not as just another test case. I felt myself relax a bit. After introducing myself and washing my hands, I noticed the mother seemed nervous. Concerned, I asked if everything was okay, and she responded.

“Perdon, solo hablamos Español.”
(“Sorry, we only speak Spanish.”)

That was another unexpected surprise! In my worrying about if I would be good enough for rotations, I almost forgot that I would also be seeing Spanish-speaking patients in the United States.

Luckily, this scene was comforting for me as well, as my medical school is in Mexico. I've had the privilege of working with Spanish-speaking patients since my first semester, and I've also taken additional language classes to improve my Spanish along the way. So, I calmly replied with a smile:

“No te preocupes; podemos usar Español.”
(“Don't worry; we can use Spanish.”)

The shock and joy the mother had that I could speak Spanish was unreal. She immediately had to know where I was from.

“De donde eres?”
(“Where are you from?”)

I told her I was born and raised in California, but I learned Spanish during my first 2 years of medical school in Mexico. She seemed surprised and mentioned that it's rare for her to meet someone who looks like her and speaks Spanish here in America.

After performing her child's 3-year-old checkup visit, she thanked me for taking the time to learn her language. She explained to me that it made it more comforting for her to speak Spanish. She worried that sometimes physicians didn't understand her concerns, especially when it came to her daughter, due to the language barrier.

When she shared this with me, I felt deeply saddened. This is an issue I've heard about since my earliest days of aspiring to enter medicine. Across the United States, many people feel underrepresented in health care. Whether it's seeing a provider who looks like them or having someone who can truly understand their language and experiences, this is a problem that urgently needs to be addressed.

According to the Association of American Medical Colleges, only about 5.7% of physicians in the United States identify as Black or African American, despite the fact that around 12% of the U.S. population falls within this group. Similarly, the U.S. Census Bureau estimates that Hispanic people make up 19% of the population, with nearly 70%—about 42 million individuals—speaking Spanish at home. A former director at the UCLA Center for the Study of Latino Health and Culture's Accelerating Latinx Leadership Institute, emphasizes the significant gap in both representation and communication in health care, noting that only 6% of physicians are Hispanic and just 2% of non-Hispanic physicians are fluent in Spanish.

Medical students from diverse backgrounds can often get overwhelmed by the demands of medical school, whether it's preparing for board exams or mastering skills like laceration repair. While these tasks are crucial, it's important to remember that your presence is equally valuable. Simply being in the room holds great significance, as it shows patients they are represented and heard. This becomes especially powerful when they can communicate in their own language, fostering a deeper connection and sense of comfort.

Looking back, attending medical school in Mexico was one of the best decisions I could have ever made. It has given me the opportunity to represent my community in the field of medicine and ensure that Spanish speakers feel understood and supported in the United States. Listening attentively to patients during their times of need is one of the most important responsibilities a physician has, and I feel privileged to be able to offer that care in English and Spanish.

References

Association of American Medical Colleges. Active physicians who identified as Black or African-American, 2021. Accessed at www.aamc.org/data-reports/workforce/data/active-physicians-black-african-american-2021 on 1 October 2024.

Balch B. The United States needs more Spanish-speaking physicians. Association of American Medical Colleges; 26 July 2023. Accessed at www.aamc.org/news/united-states-needs-more-spanish-speaking-physicians on 1 October 2024.

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